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Genomic alterations including survival motor neuron (<jats:italic>SMN)<\/jats:italic> copy number as well as deletions in <jats:italic>SMN<\/jats:italic> and Neuronal Apoptosis Inhibitory Protein<jats:italic> (NAIP)<\/jats:italic> are greatly implicated in the emergence of SMA. However, the association of such alterations with the severity of the disease is yet to be investigated. This study was directed to elucidate the molecular assessment of <jats:italic>NAIP<\/jats:italic> and <jats:italic>SMN<\/jats:italic> genomic alterations as a useful tool in predicting the severity of SMA among patients. This study included 65 SMA pediatric patients (30 type I and 35 type II) and 65 healthy controls. RFLP-PCR was employed to determine the genetic polymorphisms of the <jats:italic>SMN1<\/jats:italic>, <jats:italic>SMN2<\/jats:italic>, and <jats:italic>NAIP<\/jats:italic> genes. In addition, qRT-PCR was used to identify the expression of the <jats:italic>SMN1<\/jats:italic> and <jats:italic>SMN<\/jats:italic>2 genes, and serum levels of creatine kinase were measured using a colorimetric method. DNA sequencing was performed on some samples to detect any single nucleotide polymorphisms in <jats:italic>SMN1, SMN2, and NAIP<\/jats:italic> genes. All SMA patients had a homozygous deficiency of <jats:italic>SMN1<\/jats:italic> exon 7. The homozygous deficiency of <jats:italic>SMN1<\/jats:italic> exons 7 and 8, with the deletion of <jats:italic>NAIP<\/jats:italic> exon 5 was found among the majority of Type I patients. In contrast, patients with the less severe condition (type II) had <jats:italic>SMN1<\/jats:italic> exons 7 and 8 deleted but did not have any deletions in <jats:italic>NAIP<\/jats:italic>, additionally; 65.7% of patients had multiple copies of <jats:italic>SMN2<\/jats:italic>. Analysis of <jats:italic>NAIP<\/jats:italic> deletion alongside assessing <jats:italic>SMN2<\/jats:italic> copy number might enhance the effectiveness of the diagnosis that can predict severity among Spinal Muscular Atrophy patients.<\/jats:p>","DOI":"10.1007\/s10528-023-10657-6","type":"journal-article","created":{"date-parts":[[2024,2,22]],"date-time":"2024-02-22T18:02:40Z","timestamp":1708624960000},"page":"5051-5072","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["NAIP Gene Deletion and SMN2 Copy Number as Molecular Tools in Predicting the Severity of Spinal Muscular Atrophy"],"prefix":"10.1007","volume":"62","author":[{"given":"Abdel Nasser H.","family":"Abd El Mutaleb","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fawziya A. 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All procedures performed\u00a0and study design were reviewed and approved by the Ethical Committee in Medical Research Institute- Alexandria University.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical Approval"}},{"value":"A signed informed consent was collected from all the participants prior to enrollment in the study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to Participate"}}]}}